| NPI | 1750013819 |
|---|---|
| Doing Business As | MODERN DENTISTRY OF ROYAL OAK |
| Entity Type | Organization |
| Authorized Contact | COLLEEN DIANE SHELTON Admin 248-544-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-06-28 |